Presentation Authors: Jenna Bates*, Houston, TX, Taylor Kohn, Baltimore, MD, Katherine Rodriguez, Houston, TX, John Sigalos, Los Angelos, CA, Asad Hasan, Houston, TX, Alexander Pastuszak, Salt Lake City , UT, Larry Lipshultz, Houston, TX
Introduction: Increasingly, poor sleep is associated with poor health. Few studies have assessed the impact of sleep quality, sleep apnea, and sleep hygiene on lower urinary tract symptoms (LUTS). Here we utilize three validated sleep questionnaires to assess the relationship between sleep and LUTS.
Methods: Men presenting to a single academic andrology clinic between July 2017 and November 2017 completed the validated International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), Sleep Hygiene Index, and STOP-BANG (to assess risk of sleep apnea) questionnaires. Patients were asked about comorbidities, smoking, shift work status, body mass index (BMI), daily caffeine intake, and medication use. We performed multiple linear regressions to assess the relationship between sleep and IPSS score while controlling for age, BMI, burden of comorbidity, caffeine intake, melatonin and other sleep medication use, continuous positive airway pressure (CPAP) device use, shift work, smoking, depression status, and antidepressant use.
Results: In all, 377 men were included in this study with a mean(SD) age of 46.1(13.2) years and mean(SD) BMI of 30.0(4.6). On regression analysis, men had worse LUTS as global sleep quality decreased, as measured using the PSQI. For each point increase in PSQI score, indicating worse sleep, IPSS score increased by 0.62 points, indicating worse lower urinary tract function (p < 0.0001). Men with "very bad sleep" according to the PSQI had IPSS scores 4 points higher than men with "fairly bad sleep," 7 points higher than those with "fairly good sleep," and 10 points higher than those with "very good sleep." Men who were at high risk for sleep apnea had IPSS scores 3.2 points higher than men at low risk (p = 0.008), while the use of CPAP was associated with a 2.8 point increase in IPSS score (p = 0.045). Importantly, improved sleep hygiene was associated with significant improvement in IPSS scores (p = 0.03). Older age was associated with worse IPSS scores in all regression models (p < 0.001).
Conclusions: Poor sleep quality is significantly associated with worse LUTS, and improvement in sleep hygiene is associated with improved LUTS. Men presenting with LUTS and older men at risk for LUTS should be counseled about optimizing sleep quality to minimize the impact of sleep on LUTS.
Source of Funding: This work is supported in part by a Urology Care Foundation Summer Medical Student Award (to T.P.K.). A.W.P. is a National Institutes of Health K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the National Institute of Di